Читать книгу Nursing and Health Interventions - Souraya Sidani - Страница 17

In practice, many clients present with one or more health problems and a range of life circumstances (or context). The experience of each problem may be associated with multiple determinants or causes, occurring in different domains of health (e.g. physical, psychological) and at different levels (e.g. intrapersonal, interpersonal, environmental) (Diez‐Roux, 2011). The problems and their determinants are often inter‐related, forming a “web of causation” (Golfam et al., 2015), also called multi‐causality. Understanding these inter‐relations is essential for designing and evaluating health interventions; this can be achieved with the development of the theory of the health problem to be targeted by an intervention. The theory of the health problem is a means for integrating the determinants of the health problem and delineating the complex inter‐relationships among them (Fleury & Sidani, 2018). The theory of the health problem points to aspects of the problem amenable to change, which informs the design of interventions. Interventions based on a clear understanding of the health problem were found to be most successful (e.g. Glanz & Bishop, 2010; Prestwich et al., 2014). The theory is also useful in guiding practice; it delineates aspects of the health problem that should be assessed, thereby ensuring a comprehensive and thorough assessment and understanding of the clients' condition, as advocated in client‐centered care.